SHOULDER DISLOCATION -vs- SHOULDER SEPARATION

Image by Hellerhoff

The other day we looked at the differences between some common shoulder problems (HERE). Today we will look at the differences between Shoulder Separations and Shoulder Dislocations. Let's begin by looking at the differences between the x-rays of these two shoulders above. In order to do so we are going to briefly look at some anatomy from the picture on the left.

LEFT SHOULDER

First, take a look at the AC (Acromioclavicular) joint. It is made up of the ligaments that connect the Acromion process of the scapula (the top of the far right) to the shoulder-end of the clavicle or collar bone). Gray's Anatomy (the text book that the picture is from) calls this ligament the Superior Acromioclavicular Ligament.

Just below that is the "ball and socket" part of the shoulder joint. The head of the arm bone (the humerus) is held into the socket of the Scapula (the shoulder blade) by a group of ligaments known as the Capsular Ligament.

When the shoulder gets hit in a certain way, sustains too much stress (weightlifting, shoveling gravel, a fall), you can damage (sprain or stretch out) the Acromioclavicular Ligament. The picture below (black background) shows the different levels of severity of Separated Shoulders. Because the Acromioclavicular ligament itself is damaged, the end of the collar bone is allowed to tip upwards. Usually this is fairly slight. But as you can see from the images below, they can get progressively severe to the point they can require surgery --- depending on the degree of stretching / tearing of the Acromioclavicular Ligament.

Bear in mind that the tell-tale sign of a freshly Separated Shoulder is a painful 'bump' at the point (top) of the shoulder. An old dislocation will not typically hurt, although the bump remains. Once you have separated the shoulder, it never really goes back. You will always have the bump. Also bear in mind that this is a slow-healing injury. I separated my left shoulder about 16 years ago shoveling pickup load after pickup load of dirt for my garden. I have no real problem with it today as long as I do not get ignorant in the gym and try to bench press like I did back in the day. Unfortunately, TISSUE REMODELING does not really work on this particular injury.

Just remember, a Shoulder Separation is going to leave a painful bump on the very top of the shoulder --- at the AC (Acromioclavicular) Joint. Rarely does this require medical attention. It is a matter of letting it heal a bit, and slowly introducing activities until you can do them normally. As I just mentioned, go slowly as it is fairly easy to aggravate a Separated Shoulder. It also takes a long time (months or even years) to really heal.

SHOULDER DISLOCATIONThe Shoulder Dislocation is a more serious injury --- something you need to seek medical attention for. It is important to deal with this injury quickly. The longer a shoulder stays dislocated, the greater chance there is for complications. Also, having repeated shoulder dislocations (think of Mel Gibson's character in Lethal Weapon) leads to permanent instability, arthritis, chronic dysfunction, and chronic pain. Besides pain, swelling, and spasm, the classic sign of a Shoulder Dislocation is a hollow area at the front top of the shoulder --- the cavity left after the shoulder comes out of its socket and drops downward. Although we help lots and lots of Shoulder Problems with our Tissue Remodeling (HERE), like the Separated Shoulder, this is not one of them. Again, the Cold Laser Therapy, proper Nutritional Supplements such as LIGAPLEX, can make a huge difference in the length of time a Rehab Protocol will take (as well as its overall effectiveness).

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Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).